Intest Res.  2018 Jul;16(3):400-408. 10.5217/ir.2018.16.3.400.

Nonimmunity against hepatitis B virus infection in patients newly diagnosed with inflammatory bowel disease

• Yeo SJ
• Lee HS
• Jang BI
• Kim ES
• Jeon SW
• Kim SK
• Kim KO
• Lee YJ
• Lee HJ
• Park KS
• Jung YJ
• Kim EY
• Yang CH
• Crohn's and Colitis Association in Daegu-Gyeongbuk (CCAiD)

• KMID: 2417652
• DOI: http://doi.org/10.5217/ir.2018.16.3.400

Abstract

BACKGROUND/AIMS
This study aimed to elucidate the prevalence of hepatitis B virus (HBV) serologic markers in Korean patients newly diagnosed with, but not yet treated for inflammatory bowel disease (IBD).
METHODS
We prospectively enrolled 210 patients newly diagnosed with IBD (109 with ulcerative colitis and 101 with Crohn's disease). Hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc) levels were measured and compared with those of 1,100 sex- and age-matched controls.
RESULTS
The prevalence of chronic HBV infection (positive HBsAg, positive anti-HBc, and negative anti-HBs results) and past infection (negative HBsAg, positive anti-HBc, and positive or negative anti-HBs results) were not significantly different between the patients and controls (chronic HBV infection: IBD, 3.8% vs. control, 4.9%, P=0.596; past infection: IBD, 26.2% vs. control, 28.8%, P=0.625). The patients with IBD aged < 20 years were at a higher susceptibility risk (nonimmune) for HBV infection than the controls (IBD, 41.5% vs. control, 22.4%; P=0.018). In the multivariate analysis, an age of < 20 years (P=0.024) and symptom duration of ≥12 months before diagnosis (P=0.027) were identified as independent risk factors for nonimmunity against HBV infection.
CONCLUSIONS
The patients newly diagnosed with IBD were susceptible to HBV infection. The frequency of nonimmunity was high, especially in the patients aged < 20 years and those with a longer duration of symptoms before diagnosis. Therefore, it is necessary to screen for HBV serologic markers and generate a detailed vaccination plan for patients newly diagnosed with IBD.

Keyword

Inflammatory bowel disease; Colitis, ulcerative; Crohn disease; Hepatitis B virus; Vaccination

MeSH Terms

Colitis, Ulcerative
Crohn Disease
Diagnosis
Hepatitis B Surface Antigens
Hepatitis B virus*
Hepatitis B*
Hepatitis*
Humans
Inflammatory Bowel Diseases*
Multivariate Analysis
Prevalence
Prospective Studies
Risk Factors
Vaccination
Hepatitis B Surface Antigens

Figure

• 

  Fig. 1 Quantitative anti-HBs titer of the patients with IBD and controls. The median titer of the patients with IBD was 44.20 mIU/mL (interquartile range [IQR], 11.19–209.51 mIU/mL), and that of the controls was 59.00 mIU/mL (IQR, 8.00–360.83 mIU/mL) (P=0.031). The horizontal dot bar indicates the mean cutoff value of 10 mIU/mL. aThe IBD group mean very high level of titers.

• 

  Fig. 2 Prevalence of HBV infection serologic markers by age at the time of diagnosis. (A) HBsAg; (B) anti-HBc; (C) anti-HBs; (D) effective vaccination; (E) nonimmunity.

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